What Is NextGen NCLEX? What should you know?

Question

The Next Gen NCLEX (NGN) has been generating a lot of excitement among nursing students and educators lately. What should you know? 

What Is NextGen NCLEX?

Upon completing nursing school, the next essential step in becoming a nurse is successfully passing the National Council Licensure Examination (NCLEX). This examination serves to validate the competencies of recent nursing graduates. It demonstrates to state boards that the individual possesses the knowledge and skills to practice safely and effectively within a clinical setting. The exam undergoes periodic changes, with the National Council of State Boards of Nursing (NCSBN) updating the test plans every three years to keep pace with changes in the field. The latest version of the NCLEX exam, the NGN, has been designed to ask better questions and encourage nurses to think critically and make informed decisions when providing care.

Why did the NCLEX change?

The NCLEX is adapting to keep up with the growing demands of the healthcare system. With rapid advancements in technology and patients facing more chronic and complex illnesses, nurses now have a more challenging role than ever before. They face increasing regulations, litigation, and electronic EMRs. As the industry evolves and patient needs become more intricate, nurses are required to make complex decisions.

How has the NCLEX changed?

Graduate nurses were evaluated using new questions developed by the National Council. These questions were created after analyzing data from 2013-2014 and were included in a "special research section" of NCLEX exams from July 2017 to December 2018. Candidates taking the NCLEX-RN and NCLEX-PN exams could complete this section, which tested their clinical judgment ability. The majority of candidates (about 85%) chose to take it. NCSBN used the results to demonstrate the need for an exam revision and to test these new question types. These NGN test items are designed to simulate nurses' daily work and assess their critical thinking, judgment, and decision-making skills. They use case studies and patient scenarios that nurses may encounter in real-life clinical settings.

NextGen NCLEX Test Items



1. Extended multiple-response: The NCLEX exam features extended multiple-response items that allow candidates to select more than one answer from a comprehensive range of options.
2. Extended drag-and-drop: These questions require candidates to move or place their responses into answer spaces. They are similar to the NCLEX-ordered response format, but not all answer choices may be used. Some questions may have more options than answer spaces provided. 
3. Cloze (drop-down): In the NGN cloze question, candidates may be asked to select an option from a drop-down list. Multiple drop-down lists could exist, and candidates may have to choose the correct words or phrases within tables, charts, or sentence passages after reading a passage.
4. Enhanced hot spot items: To answer test questions, candidates can choose their answers by highlighting specific words or phrases in nursing notes, medical history, or medication records. 
5. Matrix grid: This question type allows candidates to choose multiple answers on a table. Each row or column may need to be answered. The question may present a scenario with client data, and the test-takers must assess the findings by selecting the appropriate boxes in a supporting table. This type of question measures various aspects of a topic in a single test item. 
6. Stand-alone: Bow-tie and Trend items. Candidates will encounter new question formats, including stand-alone items that only ask one question. One such type is the bow-tie question, where candidates must drag and drop answers into a bow-tie-shaped diagram. Another stand-alone question is the trend item, where candidates review information over time and select the appropriate intervention.
7. Unfolding Case Studies: The NGN exam now includes "Unfolding Case Studies" that will ask candidates to analyze medical records, make clinical judgments, and assess patient responses. These questions will be evaluated using a new scoring system that gives partial credit for questions with multiple points, unlike the previous scoring system that only marked questions as "all correct" or "all incorrect." 

Where to Find More Information on NGN 

If you're a student looking to learn more about the Next Gen exam, the NCSBN site is the best place to start. They've recently updated their NCLEX-RN and NCLEX-PN Test Plans to reflect these changes, and these plans include practice questions.

Answer 1

Test Design

Computerized Adaptive Testing (CAT) Explained:

The examination adapts its difficulty level in response to the accuracy of responses to evaluate proficiency. The test consists of 85-150 questions, with a minimum of 85 questions to be answered.

Scoring System: NCLEX questions now offer partial credit with three scoring methods.

1. 0/1 Scoring Method - You will earn one point for each correct answer and zero points for incorrect ones. This method is applicable when you have a limited number of options to choose from, such as selecting three findings.
2. +/- Scoring Method - You will earn one point for every correct answer and lose a point for every incorrect answer. This method is used for questions where you can select multiple answers for example: select all that apply.
3. Rationale Method: Points are earned only when the concept and rationale are answered correctly.

Outcome

The Next Generation NCLEX (NGN) is a pass/fail test. The outcome is determined based on three scenarios:

1.  95% Confidence Interval: The test will automatically end once the system is 95% confident in the examinee's proficiency after a minimum of 85 questions have been answered.
2. Exam's Maximum Length: The system presents 150 questions and determines if the examinee passed or failed.
3.  Run-Out-of-Time (ROOT): To pass the test, the examinee must answer at least 85 questions and reach a 95% certainty level of meeting the standard. If they don't meet these requirements, they fail. However, if they answer at least 85 questions, the test will estimate their score based on their last known proficiency. If their score is above the threshold, they pass, but if it's below, they fail.